Medication

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Taken from the NYT comments on Paul Krugman’s Op-Ed of Jan. 18, 2013.
Note that she’s just my age. So I thought it would be interesting to give her point of view.


Maggie, Brattleboro, VT

I am an 84 year old retiree, still independent. I am a retired internist who has cared for thousands of people. What can we old people do to help our national economic situation? Increasing numbers will live beyond 65 and depend on Medicare and Social Security. How many die after age 65?
Someone knows.
I have made personal decisions to reduce health care costs for myself and the nation. The last year of life is the most costly for Medicare and other simultaneous insurers.
1. I have eliminated all unnecessary drugs, taken to excess by most seniors.
2. At 84, in the twilight of an interesting life, I do not want to die in an expensive hospital, with “interventions.”
3. If I suddenly become unresponsive or seemingly in distress, I want NO CPR, no paramedics, no hospitalization, no life sustaining measures such as CPR, dialysis, respiratory assist, feeding tubes and the like. My advanced directives say this.
4. While not a religious person, I trust that God would agree with my choices for a great way to go: painless, low cost, and quiet. What a relief to me and the family and the economy. I hope that others respect my wishes.
Maggie
Jan. 18, 2013 at 8:59 a.m.REPLY You recommended this 25

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OK, I took my last Sertraline (Zoloft) last Wednesday evening, July 4, 2012. So, it’s been three days or 72 hours, plus about 12 more to account for last evening until now. Is that enough? Have I noticed any improvement in my Lymphocytic Colitis, one of the two forms of Microscopic Colitis, which I have?

Not right away. My weight has dropped another 1.6 pounds from last Wednesday morning to this (Sunday) morning. But I think the D has gotten better! (How often have I said that?) This morning I had one D around 5:30am, then I was able to sleep til about 7:30am, after taking awhile to get back to sleep.

But the encouraging thing this morning is that after breakfast I had a near normal BM. Great!

Incidentally, ever since seeing Dr. Nolan on Friday, the 29th of June, I’ve been doing the Asacol (Mesalamine) and Questran (Cholestyramine) three times a day, up from two times.

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Oh oh, there is a connection. In fact there’s a warning! There is evidence that Zoloft may make Colitis worse if not cause it. Earlier this morning I did a Google search “Zoloft Colitis” and found quite a few articles.

I’ve got to run now. More later.

Here’s the Wikipedia article on Zoloft (Sertraline). At the end of the second paragraph under Adverse Effects is the following sentence: Sertraline appears to be associated with microscopic colitis, a rare condition of unknown etiology.[108] As I said above, there are quite a few other articles on the adverse effects of Zoloft (Sertraline) on Colitis and some patient confirmations.

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OK, today is the day Dr. Cassidy removes the cataract from my right eye. We’ll be heading down to Portland to the Eyecare Medical Group around Noon.

Kate is gonna drive and zMommy will be coming along. I’m told the whole procedure will take an hour and a half. But this is the whole time I’ll be there; the actual “procedure” or removal will take about ten minutes.

I’ve been taking eye drops the last couple days, three times a day. That’s Vigamox and Nevanac. The former is an antibiotic, the latter for pain reduction. Of course, I’m not sure how well I got the drops into my eye. Guess it doesn’t matter as long as some of it goes in.

It’s now approaching 11am. Pretty soon I’ll put on a short sleeved shirt with open collar, as they request, and take the Cyclopentolate. One drop of that. I think that’s to widen the pupil. It’s the reason I can’t drive to the surgery. Also I take the Nevanac again, three times, and will have to stop on the way down so I can insert a drop.

Alright, I guess that covers it. Perhaps I can update this post when I come back, assuming I at least have one eye (the left one) to look out of.
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Yup, I’ve got one good eye now, the left one. Here it is 5:25pm and my right eye is blurry as hell. But that’s to be expected I’m told. I’ll be seeing Dr. Cassidy again in the morning (9:30am) for his further inspection and instructions for the future.

The whole procedure today was fairly painless. The only pesty thing was the inserting of the needle for the I-V in my hand. But whatever medication he gave me was definitely appreciated by me. I was quite relaxed during the whole time that Dr. Cassidy was operating, about ten minutes I guess.

Kate drove well all the way down and back. She said her pinched nerve in her neck was better. We stopped at Gorham on the way back and picked up some groceries, including Hake for supper. Over and out.

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In my younger days I mis-pronounced prostate as prostrate. When my uncle Morton had prostate problems, my uncle Gordon smiled in condescension at me when I said, “Too bad about Morton’s prostrate.”.

Well, that was then. Now I know better, being of the prostrate age myself, and having some prostrate problems. Like on Nov. 1 of last year when I fell prostrate and unconscious on the bathroom floor after taking that Cardura pill.

But also I now have real prostate problems. Not cancer, as far as I know, but BPH problems. I like the first letter of that: Benign.

Anyway, it’s turning out that the famous PSA test isn’t so useful for detecting prostrate prostate cancer after all.

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I spotted an article in the NYT online today, The Evidence Gap: The Minimal Impact of a Big Hypertension Study which at first I thought I’d bypass but then decided, what the heck, I’ll read it. Toward the end of the first page I suddenly came across mention of my least favorite medication, Cardura.

The article is about a massive hypertension study called ALLHAT, short for Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial.

The purpose of the ALLHAT was to compare four drugs for effectiveness on people over age 55, a diuretic called chlorthalidone; an ACE inhibitor called lisinopril; a calcium channel blocker called amlodipine; and an alpha blocker called doxazosin, which Pfizer sold as Cardura.

Ah, there’s my old “friend”, Cardura — who was supposed to keep me from peeing in the night but instead knocked me out cold — as part of a big study. What did they find out about it?, I wondered.

Well. I didn’t have to wait long for the answer. Here’s the very next paragraph in the article:
Pfizer’s bet on Cardura proved a big mistake. As the Allhat data came in, patients taking Cardura were nearly twice as likely as those receiving the diuretic to require hospitalization for heart failure, a condition in which the heart cannot pump blood adequately. Concerned, the Heart, Lung and Blood Institute announced in March 2000 that it had stopped the Cardura part of the trial. Ha ha. Cardura went out in 2000 and yet I take it in 2008. Amazing!

Perhaps the reason I took that Cardura pill on November 1, 2008, was that Pfizer didn’t like losing its bet on Cardura and fought back like a giant corporation. They managed to defeat a lawsuit by two patients who then went the route of a Citizen Petition. Read all about it here.

The Citizen Petition brought the FDA into the fray, a year after the original findings of the ALLHAT. Some of the outside experts at the FDA meeting claimed the ALLHAT data were not accurate while other experts disagreed. The FDA considered the net result a wash, and so, no warning was issued to doctors and patients about Cardura.

Well, I’d like to issue my own warning!

Here ye! Here ye! Here ye! I, Marden H. Seavey, issue my own warning about the dangerous medication Cardura. It caused me to faint and crash on our bathroom floor injuring my back and rib cage musculature, and I’m still sore a month later.

Worse, the little 2mg Cardura pill lowered my heart rate into the 30’s which worried the doctors at the hospital until the rate finally recovered. This was about eight hours after I had passed out. A cardiovascular specialist has given me thoroughgoing tests (echo cardiogram and Holter monitor for 24 hours), and now declares I don’t have to see him for a year.

His warning to me: Just don’t take Cardura!

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You’ve heard about the world, at least in certain respects, in my last few posts, but how am I doing now after my brush with disaster to usher in the month of November? Hey, as I like to say, I could be worse. I still do get uncomfortable at night when I try to move in bed. This endless muscle stiffness is very slow at going away. But it’s gradually improving. Other than that, I’m fine. I keep monitoring my blood pressure and find it freaky at times. I have an appointment coming up with an electrocardiologist who maybe can sort out the various electrical signals generated by my heart, i.e., the atrial fibrillation arrhythmia, the premature ventricular contractions, the interesting sinus rhythms, etc. Sounds serious, huh? Well I’ve been living with these signal types for many years and I’ve always done well on stress tests in spite of them, so, what me worry? The docs say, “Get your hiking exercise. Very important!” I missed it today. Too much blogging!
😉 😆

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Wow, I’m not going to take THAT again . There I was around 3am last Saturday morning, sitting peacefully on the toilet when suddenly I felt violently ill, and the next thing I knew my cheek was hit by a cold bathroom tile. A few seconds later I realized I had passed out. My wife helped me up off the bathroom floor and guided me back to bed.

It seems I had taken a 2mg dosage of the Doxazosin Mesylate (brand name innocuous enough: Cardura) around 10:30pm Friday evening. This was my first time with the stuff and I thought I’d give it a whirl. After all, I had a great time at the Halloween Open Mic Friday evening and particularly enjoyed singing my favorite song, with Heather Pierson’s great piano accompaniment, When the Night Wind Howls out of Gilbert and Sullivan’s Ruddigore. But it turned out it was Cardura that gave me the whirl!

This medication was prescribed for me by a urologist because of its effectiveness in treating benign prostatic hyperplasia (enlarged prostate). But also it’s a blood pressure medicine, a so-called alpha blocker, and I’m already taking a beta blocker for my hypertension. How many blockers can one tolerate? Too many blockers and blood pressure could in principle go to zero! Not good.

The info sheet on the medication, which I hadn’t read, warns about the dizziness it could produce, due to blood pressure and heart rate drop, so the advice is to take the pill at bedtime. Of course, a person with that benign prostatic hyperplasia, like me, might want to get up to go to the bathroom. End of story.

My fall on the cold bathroom floor caused quite a bruise on the side of the head and also my back and side muscles were badly bruised, so that when I got back in bed I found I couldn’t move without experiencing severe pain. So, off to the emergency room I went on a stretcher. My first ambulance ride. The Doc on call over the weekend has rearranged my hypertension and other meds, and the day after tomorrow I’ll go to my primary care provider and reevaluate the meds.

Maybe I should go off my meds entirely!!! YIPPPEEEEE! Off my meds!! Well, only for a day as a celebration if Obama wins tomorrow! If he doesn’t, maybe I’ll just double up on them and go poof.

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